Transcription

1 Non-Hodgkin s Lymphoma (NHL) and (Lymphosarcoma and reticulum cell sarcoma) Exposure to Ionizing Radiation Summary: Some evidence has been recorded of a possible connection between non- Hodgkin's lymphoma and exposure to ionizing radiation. There is possible evidence from studies conducted at Los Alamos National Laboratory. Studies of nuclear workers at other sites who have been exposed to ionizing radiation and persons exposed to the atomic bomb show an increase risk of developing non-hodgkin's lymphoma. The National Research Council s BEIR V committee did not address the issue of radiation- induced non-hodgkin s lymphoma. Non- Hodgkin's lymphoma is designated as a specified cancer under the Energy Employees Occupational Illness Compensation Program Act. Historically, non-hodgkin's lymphoma incidence and mortality have been among the highest in the state for Los Alamos County. Non- Hodgkin's lymphoma incidence and mortality in Rio Arriba County is less than most counties in New Mexico. Incidence means new cases of cancer, while mortality means deaths due to cancer. What is Non-Hodgkin s Lymphoma? Lymphoma is a general term for cancers that develop in the lymphatic system. The lymphatic system is part of the body's immune system. It helps the body fight disease and infection. Hodgkin's disease is one type of lymphoma, all others may be grouped together and referred to as Non-Hodgkin s Lymphoma. Lymphosarcoma or reticulum cell sarcoma can be other names for Non-Hodgkins Lymphoma. Lymphomas account for about 5 percent of all cases of cancer in this country. Because lymphatic tissue is present in many parts of the body, non-hodgkin's lymphoma can start almost anywhere in the body. This type of cancer can spread to almost any part of the body, including the liver, bone marrow, and spleen. (National Cancer Institute) Findings of Human Health Research Studies Human health research studies compare the patterns of disease among groups of people with different amounts of exposure to a suspected risk factor. Below are results reported from such studies of non-hodgkin s lymphoma among people exposed to ionizing radiation. All of these studies found possible increases of non-hodgkin s lymphoma among certain groups of exposed workers. Statistically significant is a term used to mean that the connection between the health outcome and the exposure was strong enough that it was unlikely to be due to chance. Note that some of the findings were based on only a few cases. The research included incidence studies, which look at new cases of cancer. These can track health more quickly and accurately than mortality studies of deaths due to cancer. + Evidence of a dose-response relationship (strongest evidence) Page 71

2 Studies of Los Alamos National Laboratory (LANL) Workers Research conducted of LANL workers provides the most direct evidence about possible relationships between a health problem and workplace exposures at LANL. UC & Zia Employees: A possible increased incidence of lymphosarcoma and reticulosarcoma was found in a study of Anglo males who were employed for at least one year between 1969 and The finding was based on just four cases. 16 Mortality Study up to 1991: Possible increased deaths were found to be due to lymphosarcoma in an analysis of 3,775 males who were monitored for plutonium while employed between 1943 and Based on just one case, which occurred in a worker with body burden greater than 2 nanocuries (a measure of radiation exposure). 21 Zia Study (unpublished): Possible increased deaths were found in an analysis of 564 females employed by Zia Company between 1946 and 1978 who were monitored for either plutonium or external radiation. Findings were based on just one case. 15 Studies of Other Nuclear Workers in the United States The next most relevant evidence comes from studies of workers in similar occupations with the same types of exposures. Listed below are studies that looked at non-hodgkin s lymphoma and workplace exposures among nuclear workers in other parts of the United States. Hanford, Washington: A possible increase in deaths to lymphomas was found in a study of 35,000 males who were employed between 1943 and 1972, and then followed through Savannah River Site: A possible increase in deaths in the category of lymphomas that includes NHL was found among white male hourly employees who were hired before UC & Zia Employees: A possible increased incidence of lymphosarcoma and reticulosarcoma was found in a study of Anglo males who were employed for at least one year between 1969 and The finding was based on just four cases. 16 Mortality Study up to 1991: Possible increased deaths were found to be due to lymphosarcoma in an analysis of 3,775 males who were monitored for plutonium while employed between 1943 and Based on just one case, which occurred in a worker with body burden greater than 2 nanocuries (a measure of radiation exposure). 21 Zia Study (unpublished): Possible increased deaths were found in an analysis of 564 females employed by Zia Company between 1946 and 1978 who were monitored for either plutonium or external radiation. Findings were based on just one case Evidence of a dose-response relationship (strongest evidence) Page 72

3 Studies of Other Nuclear Workers World-Wide Below are studies of nuclear workers outside of the United States that looked at non-hodgkin s lymphoma in connection with radiation exposures. Sellafield, England: A possible increase in non-hodgkin s lymphoma deaths was observed in a study of 5,203 plutonium workers who were employed between 1947 and 1975, and then followed through 1992, when compared to non-radiation workers and to other radiation (non- Pu) workers. 3 Atomic Energy Establishment of U.K.: A possible increase was found in non-hodgkin s lymphoma deaths in a study of radiation workers who were employed between 1946 and 1979, and then followed through Rocky Flats, Colorado: A possible increased deaths due to lymphosarcoma and reticulum cell sarcoma was observed in a study of 5,413 men employed for at least two years between 1952 and 1979 (This study assumed a latent period of 2 or 5 years). Findings were based on just one case. 28 Portsmouth, Ohio: Possible increased deaths were seen due to lymphoreticulosarcoma in a study of 8,887 workers employed for at least one day between 1954 and 1991, followed through Studies of Other Ionizing Radiation Exposures Studies among other groups of people who were not nuclear workers can also be significant as evidence of possible increases in non-hodgkin s lymphoma among those who have been exposed to ionizing radiation. Most other research has been conducted of people exposed to atomic bombs. Atomic Bomb Survivors: A possible increase has been observed in non-hodgkin s lymphoma deaths in A-bomb survivors who were followed through * Other Research and Policy Findings Is Non-Hodgkins Lymphoma Considered Radiation-Sensitive? The National Research Council advises the U.S. government on scientific matters. Their Committee on Biological Effects of Exposure to Ionizing Radiations (BEIR) V reviewed sensitivity of parts of the body to radiation. Their findings are based mostly on studies of cancer + Evidence of a dose-response relationship (strongest evidence) Page 73

4 among atomic bomb survivors, as well as on some of the available information on the biology of the body, animal studies, and other evidence. The greatest risk is at high exposure levels. The National Research Council s BEIR V committee did not comment on the radiationrelatedness of non-hodgkin s lymphoma. Is Non-Hodgkins Lymphoma a Specified Cancer Under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA)? Yes. Non-Hodgkin s lymphoma, Lymphosarcoma and reticulum cell sarcoma are is a specified cancer under the EEOICPA consideration of Special Exposure Cohorts. Policy makers have identified certain types of cancer among energy employees at nuclear facilities, including those employed at Los Alamos National Laboratory, as being potentially related to occupational exposures under the EEOICPA. What Are Other Risk Factors for Non-Hodgkin s Lymphoma? In considering the cancer risk from exposure to ionizing radiation at work, it is important to understand other risk factors. Below is a list of other possible risk factors for Non-Hodgkins Lymphoma. Drinking water contamination. Contamination of drinking water with nitrate, a chemical found in fertilizers, may be associated with an increased risk of non-hodgkin's lymphoma (NHL), particularly in agricultural areas, a National Cancer Institute (NCI) study suggests. Chemical exposures. People who work extensively with or are otherwise exposed to certain chemicals, such as pesticides, solvents, or fertilizers, have a greater chance of developing non-hodgkin's lymphoma. Poor Immune System. Non-Hodgkin's lymphoma is more common among people with inherited immune deficiencies, autoimmune diseases, or HIV/AIDS, and among people taking immunosuppressant drugs following organ transplants. Viruses. Human T-lymphotropic virus type I (HTLV-1) and Epstein-Barr virus are two infectious agents that increase the chance of developing non-hodgkin's lymphoma. These factors may add to any risk due to workplace exposure to ionizing radiation. The likelihood of getting non-hodgkin's lymphoma increases with age and is more common in men than in women. Smoking is not a risk factor. Rates of Non-Hodgkin s Lymphoma Cancer in Exposed Counties + Evidence of a dose-response relationship (strongest evidence) Page 74

5 Los Alamos County Rates of non-hodgkin s lymphoma incidence and mortality were very high in Los Alamos County. Los Alamos County: Ranked first highest in incidence of non-hodgkin s lymphoma and Ranked third highest in mortality among the 33 counties in New Mexico from 1970 to In the early 1970 s the rate in Los Alamos County was considerably higher than New Mexico or the U.S.. 32 From 1970 to 1990, it was up to twice the expected rate. 35 In recent years, about three to four cases have occurred annually. Rio Arriba County Rates of non-hodgkin s lymphoma incidence and mortality in Rio Arriba County were among the lowest third of counties. Rio Arriba County: Ranked 25th in incidence of non-hodgkin s lymphoma and Ranked 23 in mortality for NHL among the 33 counties in New Mexico from 1970 to The findings suggest that more needs to be done to prevent, diagnose and treat non-hodgkin s lymphoma in Los Alamos County. + Evidence of a dose-response relationship (strongest evidence) Page 75

Leukemia and Exposure to Ionizing Radiation Summary: Strong evidence has been recorded of a possible connection between forms of leukemia and exposure to ionizing radiation. This evidence is based upon

Lung Cancer and Exposure to Ionizing Radiation Summary: Studies conducted at the Los Alamos National Laboratory and other nuclear facilities suggest an increased likelihood of developing lung cancer for

Cancer and Workers Exposed to Ionizing Radiation A Review of the Research Literature May 2003 Cancer and Workers Exposed to Ionizing Radiation A Review of the Research Literature May 2003 Center for Environmental

The Compensation Scheme for Nuclear Industry Workers in the United Kingdom Richard Wakeford The Dalton Nuclear Institute, The University of Manchester, Manchester, UK Nuclear Installations Act 1965 Imposes

Care and Problems of The Circulatory System Chapter 17 Lesson 2 Care of the Circulatory and Lymphatic Systems Most of the risk factors related to problems with your circulatory system are within your control.

Stomach cancer risks and causes Useful information Contents This information is about possible risk factors and causes for stomach cancer. Some factors may increase the risk, while others may lower it.

Are 50/60 Hz magnetic fields carcinogenic to humans? Michel Plante M.D. Magnetic fields are present everywhere in our environment. They are commonly measured in Tesla (T), the international unit for magnetic

What is Non-Hodgkin's Lymphoma? Non-Hodgkin's lymphoma is a cancer which affects cells in the lymphatic system called lymphocytes. The various types of non-hodgkin's lymphoma are divided into 'high grade'

1 ACUTE MYELOID LEUKEMIA (AML), ALSO KNOWN AS ACUTE MYELOGENOUS LEUKEMIA WHAT IS CANCER? The body is made up of hundreds of millions of living cells. Normal body cells grow, divide, and die in an orderly

Chapter 15 Multiple myeloma Peter Adamson Summary In the UK and in the 199s, multiple myeloma accounted for around 1 in 8 diagnosed cases of cancer and 1 in 7 deaths from cancer. There was relatively little

Mutations Mutations: 2 general ways to alter DNA Change a single DNA base Or entire sections of DNA can move from one place to another What is a mutation? Any change in the nucleotide sequence of DNA Here

Cancer in Scotland April 2014 First published in June 2004, revised with each National Statistics publication Next due for revision October 2014 Information Services Division NHS National Services Scotland

Six Degrees of Separation No More: Using Data Linkages to Improve the Quality of Cancer Registry and Study Data Prepared for the 138th Annual Meeting of the American Public Health Association Denver, CO

RADIATION THERAPY FOR Facts to Help Patients Make an Informed Decision TARGETING CANCER CARE AMERICAN SOCIETY FOR RADIATION ONCOLOGY FACTS ABOUT The lymphatic system is a network of tiny vessels extending

It s only human to wonder what causes disease. After a diagnosis, you may ask, How in the world could this have happened? What caused me to get leukemia? Nobody knows. There are many theories and ideas

MayoClinic.com reprints This single copy is for your personal, noncommercial use only. For permission to reprint multiple copies or to order presentation-ready copies for distribution, use the reprints

This information is an extract from the booklet Understanding lung cancer. You may find the full booklet helpful. We can send you a free copy see page 7. The lungs Contents The lungs Types of lung cancer

MEDIA FACTSHEET CANCER EXPLAINED What is cancer? Cancer is a disease which occurs when changes in a group of normal cells within the body lead to uncontrolled growth causing a lump called a tumour; this

Hodgkin Lymphoma Understanding your diagnosis Let s Make Cancer History 1 888 939-3333 cancer.ca Hodgkin Lymphoma Understanding your diagnosis When you first hear that you have cancer you may feel alone

Public Health Division Hepatitis C Infections in Oregon September 214 Chronic HCV in Oregon Since 25, when positive laboratory results for HCV infection became reportable in Oregon, 47,252 persons with

INVESTIGATION OF MULTIPLE MYELOMA IN THE AREA OF WAPPINGERS FALLS, ZIP CODE 12590, DUTCHESS COUNTY, NEW YORK Prepared by the Cancer Surveillance Program Bureau of Chronic Disease Epidemiology and Surveillance

North America Canada Canadian 1951 Schmidt & Popham (1981) 1951 70 9 889 alcoholic men, aged 15 years, admitted to the clinical service of the Addiction Research Foundation of Ontario between Death records

Division of Epidemiology, Environmental and Occupational Health Consumer and Environmental Health Services FACTS Cryptosporidium in Drinking Water What Is Cryptosporidium? 3 Why Is Cryptosporidium a Concern

Cancer is a group of more than 100 related diseases. Normally, cells grow and divide to produce more cells to keep the body healthy. Sometimes, this process goes wrong. New cells form when the body doesn

RADIUM DIAL PAINTERS What Happened to Them? Most everyone has heard about the tragedy that befell the young women who became dial painters. Their well-paying jobs, painting the hands and faces of clocks

Non-Hodgkin Lymphoma Understanding your diagnosis Non-Hodgkin Lymphoma Understanding your diagnosis When you first hear that you have cancer, you may feel alone and afraid. You may be overwhelmed by the

Produced 28.02.2011 Revision due 28.02.2013 Symptoms of Hodgkin lymphoma Lymphoma is a cancer of cells called lymphocytes. These cells are part of our immune system, which helps us to fight off infections.

Cancers All Types Cancer was the leading cause of death in Contra Costa. The most commonly diagnosed cancers in the county were prostate, breast, lung and colorectal cancer. Lung, colorectal, breast and

INVESTIGATION OF CHILDHOOD ACUTE MYELOID LEUKEMIA IN THE AREA OF THE VILLAGE OF CLYDE, WAYNE AND SENECA COUNTIES, NEW YORK Prepared by the Cancer Surveillance Program Bureau of Chronic Disease Epidemiology

Produced 21.03.2011 Revision due 21.03.2011 Lymphomas after organ transplantation People who have undergone an organ transplant are more at risk of developing lymphoma known as post-transplant lymphoproliferative

Molecular mechanisms of carcinogenesis Nik Hodges School of Biosciences N.Hodges@bham.ac.uk Aims What is cancer at the cellular level? How do chemical and physical agents cause cancer? How do we test for

Alcohol Liaison Service Liver Disease Information Introduction Most liver diseases do not show symptoms and when they do, the symptoms are often vague. There are hundreds of liver disorders and some are

Get the facts about exposure to I-131 Radiation U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute Table of Contents How Americans Were Exposed to I-131...

IAEA-TECDOC-867 Significant incidents in nuclear fuel cycle INTERNATIONAL ATOMIC ENERGY AGENCY The IAEA does not normally maintain stocks of reports in this series. However, microfiche copies The originating

The Immune System 2 Types of Defense Mechanisms Immune System the system that fights infection by producing cells to inactivate foreign substances to avoid infection and disease. Immunity the body s ability

INSTRUCTION CONCERNING RISKS FROM OCCUPATIONAL RADIATION EXPOSURE This instructional material is intended to provide the user with the best available information concerning what is currently known about

Cervical cancer is the second most common cancer among South African women *SA Statistics as per National Cancer Registry (NCR) 2007 What is cervical cancer? Cervical cancer is a type of cancer that occurs

Maria Dalbey RN. BSN, MA, MBA March 17 th, 2015 2 Objectives Participants will be able to : Understand the Pathogenesis of Tuberculosis (TB) Identify the Goals of Public Health for TB Identify Hierarchy

HIV AND AIDS for CNA's & HHA's INTRODUCTION The human immunodeficiency virus (HIV) is a virus that is transmitted through sexual contact or contact with infected blood. Infection with HIV is one of the

infoaging guides BIOLOGY OF AGING STEM CELLS An introduction to aging science brought to you by the American Federation for Aging Research WHAT ARE STEM CELLS? Stem cells are cells that, in cell cultures

Section 1 HIV and AIDS Today What Are HIV and AIDS? Human immunodeficiency virus (HIV) is the virus that primarily affects cells of the immune system and that causes AIDS. Acquired immune deficiency syndrome

Cancer of the Pancreas Definition: Cancer of the pancreas forms in either the exocrine cells or the endocrine cells that make up the pancreas. 1 Exocrine tumors make up the majority of pancreatic cancer.

Acute Myeloid Leukemia Introduction Leukemia is cancer of the white blood cells. The increased number of these cells leads to overcrowding of healthy blood cells. As a result, the healthy cells are not

CHAPTER 2: UNDERSTANDING CANCER INTRODUCTION We are witnessing an era of great discovery in the field of cancer research. New insights into the causes and development of cancer are emerging. These discoveries

Introduction: New Hampshire Childhood Cancer New Hampshire, Childhood Cancer, January 2009 Issue Brief Cancer in children is relatively uncommon, impacting fewer than twenty two of every 100,000 children

APPENDIX 1 NHS Barking and Dagenham Briefing on disease linked to Asbestos in Barking & Dagenham 1. Background 1.1. Asbestos Asbestos is a general name given to several naturally occurring fibrous minerals

Introduction 1.1 Introduction: About 10,500 new cases of acute myelogenous leukemia are diagnosed each year in the United States (Hope et al., 2003). Acute myelogenous leukemia has several names, including

Public Health Activities & Services Inventory Technical Notes COMMUNICABLE DISEASE CLINICAL SERVICES, SURVEILLANCE AND CONTROL In 2014, decision was made to adopt number of national public health activities

Track 3: Goals of therapy I was just diagnosed, so my doctor and I are deciding on treatment. My doctor said there are several factors she ll use to decide what s best for me. Let s talk about making treatment

An analysis of cancer risk experienced by fire fighters who were trained at Fiskville Background Cancer Council Victoria was commissioned by CFA to perform an analysis of cancer risk for Country Fire Authority

Useful information for cancer patients Contents This information is an overview of treatments for primary liver cancer. There are sections on Primary or secondary cancer The main treatments for primary

Module Three Risk Assessment 136 Module Three Introduction to Risk Assessment Time Allotted: 90 Minutes Objectives: Upon completion of this module, the learner will be able to # Define and understand the

CRITICAL ILLNESS CONVERSION PACKAGE Converting your Critical Illness Coverage from the Group Policy to an Individual Policy Act now to avoid an interruption in coverage. This brochure sets forth the conditions

LYMPHOMA IN DOGS Lymphoma is a relatively common cancer in dogs. It is a cancer of lymphocytes (a type of white blood cell) and lymphoid tissues. Lymphoid tissue is normally present in many places in the

ESSENTIALS Lymphoma Diagnosed with Lymphoma? It s important to understand everything you can about your diagnosis, treatment options, and places to go for support. This will help you make treatment decisions

Underwriting cancer In this issue of the Decision, we provide an overview of Canadian cancer statistics and the information we use to make an underwriting decision. The next few issues will deal with specific

Component 3-Terminology in Healthcare and Public Health Settings Unit 4-Blood, Lymphatic and Immune Systems This material was developed by The University of Alabama at Birmingham, funded by the Department

The Broad Benefits of AIDS Research Many new treatments for diseases such as cancer, hepatitis and heart disease have arisen from research on HIV/AIDS. Since the beginning of the epidemic, AIDS research